Lifestyle interventions and implementation for coronary artery disease in populous Asian Countries: a scoping review

Abstract Background Heart disease is rapidly increasing across Asia, accounting for a significant public health challenge due to its substantial contribution to the global mortality rate. Rapid urbanisation in populous Asian Countries has contributed to lifestyle changes that increase cardiovascular risk. Modifying these risk factors through lifestyle changes is important for improving outcomes for people with coronary artery disease (CAD). However, despite the development of various lifestyle interventions, it remains unclear how these interventions are being implemented and adapted across the diverse Low-and Middle-income countries (LMICs) contexts within Asia. This scoping review aimed to map lifestyle interventions among people with CAD in the ten most populous LMICs in Asia, examine lifestyle-related outcomes and implementation, and identify the gaps. Methods Following the Joanna Briggs Institute (JBI) scoping review guidance, seven databases were searched (CINAHL, MEDLINE, British Nursing Index, Cochrane CENTRAL Register of Clinical Trials, PsycINFO, Scopus, and Embase), and three additional sources. Primary studies that focused on lifestyle interventions for CAD conducted in the ten most populous LMICs in Asia were included. Title and abstract, as well as the full text, were screened by two independent reviewers. Data from all included studies were narratively synthesised. Results Thirty-seven unique studies met the inclusion criteria. Interventions were grouped into three categories by primary components: psychoeducation alone ( n = 11, 30%), psychoeducation with tailored lifestyle changes ( n = 22, 59%), and psychoeducation with specific interventions ( n = 4, 11%). Interventions combining psychoeducation with tailored lifestyle changes appeared most promising for improving lifestyle-related risk factors, particularly diet and physical activity. Findings should be interpreted cautiously, given variations in study quality. Only five studies reported feasibility and acceptability, and none reported sustainability outcomes, limiting understanding of the potential for real-world implementation and long-term impact. Conclusions Lifestyle interventions for CAD in populous Asian LMICs have mainly focused on lifestyle-related outcomes, with limited attention to implementation. Future research should prioritise high-quality studies that examine both lifestyle-related outcomes and implementation outcomes. Strengthening evidence on adaptation, scalability, and sustainability could support the translation of effective interventions in research settings into routine care, thereby expanding their potential impact for people with CAD in LMICs.